On the road to PACS--confronting the issues

In 1992, PACS became a serious consideration for me, the new administrative director of medical imaging, and a team approach seemed the sensible means to a topic so large. Even with our limited knowledge of PACS at that time, the team knew it would take years to deploy a PACS system fully. Members realized it would be one thing to design a complete PACS and quite another to break the whole into functional, logical and compatible parts. Yet how could we plan for something so sophisticated when we couldn't even agree where to begin? The team, recognizing the financial challenges of calculating cost/benefits, finally determined that the cost of PACS would exceed obvious savings. Ultimately, we determined that PACS efficiencies would enable us to go after new business. But were there hidden costs? How could we balance costs with benefits that are seemingly valid but hard to quantify? To answer such questions, the team broke the process into steps and planned each part of every step. Implications for PACS outside the radiology department became an issue. How would the PACS, RIS and transcription systems work together to handle images and reports? What about referring physicians? Will patient care improve? After inviting major image-printing vendors to make presentations for a print network, the team selected a firm endorsed by our information technology services department. Where once there was confusion, the team accomplished its goals of reducing costs, improving efficiency, and maintaining high standards for patient care.